Tuesday
May242011

Dental cavities: Preventable and curable?

The Quick Answer:  If you or a family member gets one cavity in three years, it’s not just an unnecessary expense that will lead to future pain and expense; it’s also a wake-up call to take preventative action.  Buy more fluoride?  No!  Eat less sugar (and more whole foods, including green salads).

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Here’s a fresh look at a common childhood disease: dental cavities (or caries).  The chronic diseases—type 2 diabetes, heart disease, cancer, autoimmune diseases, etc.—may take decades to develop, but cavities, which have a shared cause, can develop in baby teeth.  There’s a saving grace in the baby tooth cavity—if taken seriously, it’s an early warning that preventive change is needed to save the permanent teeth that follow.  Dental caries are highly preventable and curable, if caught early, by diet reform.

Dental cavity questions:

•  How big a problem is dental decay?   Cavities is the single most common chronic childhood disease (over 50% of children 5-9 years have at least one cavity; 78% of 17-year-olds do.  (How do 22% reach 17 with none?)

•  What causes cavities?  Sugar, mainly.  Bacteria that live in the plaque on your teeth use sugar to produce acid that can demineralize tooth enamel.  The body can repair this through remineralization but only if the plaque isn’t too acidic.

•  Can cavities be prevented?  Technically, yes, but you must move beyond the advice of the old dental establishment and the government.  If you Google “dental cavities, prevention” you will get official guidance on brushing & flossing, fluoridation, dental sealants, and regular visits to your dentists.  This is all good, it’s certainly a good business and does reduce decay, but history shows it won’t prevent or cure cavities.  Surprisingly, diet—the major factor—gets little mention.

•  So, can people actually prevent and even cure cavities?  Pretty much, but there are issues of family history, including genetics, and the fact that you’re starting well after your teeth were formed.

•  Is preventing and curing cavities a recent discovery?   No.  Important discoveries were made way back in the 1920s and 1930s and then forgotten.  So we should remember two pioneering women:  Dr. May Mellanby, and Mrs. Weston Price.

Dr. May Wellanby was the wife of Dr. Edward Wellanby who solved the problem of rickets (like caries, a bone disease) and contributed to the discovery of vitamin D.  His wife, a brilliant scientist in her own right, studied the epidemic of dental caries using dogs and then humans.  She found diet combinations that drastically reduced cavity formation and actually healed smaller cavities.  May Wellanby published her discoveries in 1924 (credit to Stephan Guyenet for this summary):

•  A diet with adequate minerals, particularly calcium and phosphorous (the ratio is important), is critical;

•  The diet must also include the fat-soluble vitamins, especially vitamin D which is also obtained from sunlight;

•  Dr. May Wellanby recommended a varied diet of whole foods, including dairy, and cautioned against excessive sugar and [refined] grain intake.

Mrs. Weston Price didn’t leave a record of her work; her contribution was to assist her husband during the ‘30s on expeditions around the world to the most primitive indigenous people they could find.  Their mission was to study the dental health of indigenous people who had not yet adopted the Western diet of refined foods, and compare them to their cousins who had moved to the city and converted to the modern diet.  Weston published his findings in the 1939 book Nutrition and Physical Degeneration:

•  Price found that for the same indigenous population, dental cavities were 35 times higher (that’s 3400% more) on the modern refined, sugary, diet, than on the traditional diet. 

•  Traditional diets were not only protective against cavities; they also resulted in well-formed dental arches in newborns.   Their cousins born in the city had the crowded malformed dental arches that delight the orthodontist.

•  Price visited tribal people all over the world who lived in varied climates and ate different diets.  What they had in common was an evolved food tradition based on natural foods and game at hand that sustained health. 

Preventive Dentistry:

Here we have a familiar story:  science has discovered a great deal about how caries develop, but we must turn to food traditions to learn how we can prevent them.  When scientists studied dental plaque—the coating on your teeth—they found a surprisingly complex community of bacteria that they gave a new name: biofilm.  Many of the bacteria in biofilm produce acid and when there is too much acid (the pH has to drop below 5.5) tooth enamel is demineralized, or eaten away.  When the pH is above 5.5 (less acidic) enamel can be remineralized, or repaired if given a healthy diet.  Your saliva is key to a healthy acid level.

The biofilm is constantly bathed in saliva.  Saliva, 98% water and sometimes called the blood supply for the mouth, is a rich broth that can buffer excess acid; it contains minerals, proteins, antibacterial agents, and enzymes needed for digestion of food.  The mouth produces about a liter of saliva each day, so drinking adequate water is as important as a healthy diet.  Prescription drugs present a special problem; there are around 3000 medications that have the side effect of “dry mouth,” which accelerates the formation of caries and gum disease.  If this warning is on the package insert of a drug you take, consult your dentist.

I had a phone interview with Dr. Cliff Sorensen, who practices preventive dentistry in Ogden, Utah.  I had read about Dr. Sorensen’s work so gave him a call, thinking that because he had once dated both my future Beautiful Wife and one of my charming sisters, he would talk with me.  We had a great conversation about saliva, biofilm, acid-producing bacteria, caries, and the difficulty of getting people to change self-destructive habits.  Dr. Sorensen gave up drill-and-fill dentistry, at considerable personal expense, when he became convinced that, for most, dental caries was preventable and curable.  As explained, he provides a cariogenic assessment and based on the outcome, provides guidance and support as appropriate.  (I like that word, cariogenic, meaning cavity or carie-producing.)

Dr. Sorensen doesn’t give nutrition advice, except to eat a healthy low-sugar diet.  I am not aware of any dentist who does; as you know, the subject is complex and the science incomplete.  But the guidance of science, tradition, and scripture combined can give us the best possible answer and that is the goal of this blog.  For example:

•  Cariogenic foods begin with sugar, but include refined and processed foods too.  Growth of the caries epidemic has paralleled our growing sugar appetite.  So sugary drinks and snack foods are a problem.  Research suggests eating less than 33-44 pounds of sugar a year will protect against dental caries.  This can be accomplished with the three sugar Healthy Changes (found here, here, and here), based on meeting the AHA’s maximum intake of six (women) to nine (larger men) daily teaspoons, which is about the proposed 33-44 pound maximum. 


•  Protective (non-cariogenic) dietary includes a variety of whole foods including dairy, plus adequate vitamin D (discussed here) as suggested by Dr. May Wellanby nearly 80 years ago.  Calcium and phosphorous are important minerals for bone health.  It's well-advertised that milk and dairy supply calcium; it's less well-known that plants are an essential source.  An important plant source is the leafy green vegetables used in salads.


Comment:  Share your favorite salad recipes, or your experience preventing cavities. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

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Reader Comments (17)

I think salads are a great way to use up whatever is in your fridge. I usually like a spring mix of greens and then throw in whatever veggies I have on hand. In the summer I love spinach salad with strawberries and walnuts and maybe a little blue cheese. I usually mix up my own dressing-olive oil, balsamic vinegar, dijon mustard and a squirt of honey.

Thanks for a great post. Another great reason to cut more sugar out of my diet!

May 25, 2011 | Unregistered CommenterAshley

I always knew less sugar for teeth, but it's interesting to think about the remineralization.

I love a salad with peas, arugula, mint and romano cheese. Usually I make a dressing with honey, olive oil, lemon and salt and pepper. It's refreshing and springy.

May 26, 2011 | Unregistered CommenterMcKenzie

Our family's new favorite salad is a take on Wendy's new Chicken Pecan Salad (I can't remember the name exactly). We toss together some greens, diced apple, dried cranberries, toasted pecans (or walnuts) and bleu cheese crumbles and toss with the light raspberry vinaigrette. Soooo yummy!

May 26, 2011 | Unregistered CommenterMelissa

I'm a single mom and it sounds so boring, but I buy an organic spring mix and every morning while I'm making breakfast and packing lunch, I put some in the collander, rinse it, put in on a towel to dry and it gets a squirt of salad dressing and it is the first course of my daughter's breakfast. I put what she doesn't eat into a container for me to bring to work to eat with lunch. It's so basic - but she enjoys it and so do I - even without any extras, those leafy greens are good.

May 26, 2011 | Unregistered CommenterElizabeth

Once again Skip, interesting. Two things come to mind:

I used to ,for free, tend/watch a child daily for about 60 hrs a week. I did this for just under 2 yrs. His parents were overworked and going through a horrific trial.He was an only child and his parents were tired from the trial they were going through. The just wanted sleep. They would put their son to bed every night with bottles of, formula later milk, juice, (i know cringe now) Kool-aid, or pop. I would counsel against it, but only to deaf ears. Their son lost every baby teeth to cavities, by the age of 4. He went another 2-3 years with baby dentures/bridges....no joke. I think there was a family sensitivity to begin with and all that sugar exasperated it. I am no dentist.

I have 7 children, but over the 20yr of our marriage we have taken in 2-3 other children. Some as long as 10 yrs. We are not rich, so to stretch our food and get the most from our budget, most days I serve fruit/ nut/finger veggie platter before lunch , a salad or veggie or soup before dinner. Yes for health,but mostly to fill up the children before the expensive part of the meal( wish I had this blog yrs ago ) . I like, Elizabeth,pack the left overs in teens lunches or my lunch :).

There are so many "hidden" reasons to follow the Word of Wisdom, it has given me a greater appreciation for the Lord in His Goodness and Joseph and Emma Smith for their inquiry. It makes sense that the Creator of our beings want the best for our bodies....machines...tabernacles...spirits.

May 26, 2011 | Unregistered CommenterHeather

My favorite green salad recipe right now:

Baby spinach or spring mix or both
1 chopped apple
feta cheese
toasted slivered almonds
1 T or so of finely chopped red onion

Dressing:
1/4 cup olive oil
1-2 T red wine vinegar
A squirt of mustard
A dash of sugar if you like it less vinegary

May 26, 2011 | Unregistered CommenterApril

I mostly eat garden type salads but I like a good greek-ish salad every now and then.

1 cup Romaine
1/4 cup Feta
1/4 cup Olives
1/4 cup Tomatoes
A sprinkle of whatever nuts I have on hand
Drizzle of Italian dressing or olive oil & pepper.

May 26, 2011 | Unregistered CommenterRill

This subject is a particular passion of mine.

I completely agree that good diet is the best way to prevent cavities. As a breastfeeding mother with a nutritiously dense diet, I was shocked when my beautiful daughter showed signs of tooth decay at just 18 months. After taking her to a dentist and learning that she indeed had 8 cavities at such a young age, my husband and I did an incredible amount of research on this subject. We read the work of Weston A. Price and many others. Our story is a long one, but here is a theory based on what we've read; based on conversations with multiple dentists and other practitioners; and based on my personal health history and my child’s babyhood.  I offer this in hopes that others can learn from my experience.

I believe that I was deficient in calcium and magnesium (and possibly other minerals) during my pregnancy with my first daughter.  My deficiencies may have been the result of a dairy intolerance (unrecognized at the time) from my own childhood.  In addition, during my years as a dancer in high school and college, my diet was perhaps not adequate, and I likely did not have strong reserves of minerals in my body.  Since baby teeth are formed in utero, my deficiencies may well have resulted in daughter’s very soft baby teeth. So, even though I had an excellent diet while breastfeeding and my daughter herself had a healthy, low-sugar diet, her baby teeth still suffered.

To make matter’s worse, I had “over-supply of breastmilk” (probably also related to dairy intolerance). This caused my daughter to spit up excessively as an infant. At any rate, the first dentist we saw said that she sees the worst decay in young children who spit up often as babies. Spitting up affects the acidity in the mouth - which impacts decay, as you discussed in this post. One recommendation I have for parents with “spitty babies” is to consider wiping out their baby’s mouths after feeding/spitting up.

When I pieced all of these details together (my daughter was two years old), I started taking a magnesium supplement (Peter Gilliham's CALM, which is considered to be very easily absorbed), and I experienced a very noticeable change in my body.  I started sleeping very deeply; I stopped having frequent headaches; and I noticed other changes.  As well as taking the magnesium supplement, I focused intently on improving my diet and, gratefully, our second daughter has excellent tooth health - no cavities or decay at all.

To make a long story short, over the course of five months and five dentist visits, our wonderful pediatric dentist successfully treated our older daughter’s decayed teeth. Those dentist visits were some of my hardest mothering moments. However, I am so grateful to say that my daughter (now almost 6) has been back to the dentist three or four times since, and she has excellent tooth health and strong adult teeth now coming in.

I encourage all mothers-to-be to eat a nutritiously dense diet, and I thank you, Skip, for your work in educating us and sharing your knowledge!

May 26, 2011 | Unregistered CommenterZane

A good healthy change going into salad season. But we tend to eat a lot fewer salads in the winter months. Eating what's in season, you know?

So far my kids have had no cavities (knock on wood!). I'm pretty strict about the limiting sugary drinks/processed foods I bring into our home. I simply can't get them to TOUCH a green leafy vegetable, though. Maybe you know some magic for getting 4 and 6 year-olds to eat them, eh Skip?

May 26, 2011 | Unregistered Commenterqueenann

Great post! I am a big fan of raw milk and raw sunshine (all in appropriate moderation). I think it does wonders for my teeth and my mood. There was a hint in one of your linked posts about the connection between adolescent girl's intake of calcium and long range risk of osteoporosis. I would be interested in hearing more about that.

As for salads, I like to dress my salads with lacto-fermented beets or carrots (great recipies for making them in Nourishing Traditions, by Sally Fallon) which allows me to give another nod to Westin Price.

May 26, 2011 | Unregistered CommenterGreg

Zane brings up an interesting point about mineral deficiencies--would love to learn more about that in a future post.
I just read the other day about calcium magnesium deficiencies causing insomnia.
Thanks for the info. It has made me want to eat less sugar because I will do anything to avoid the dentist drill.
My favorite salad is Wendy's Chicken Apple Pecan with pomegranate dressing. Lots of sugar in the dressing so I only use a little bit.

May 27, 2011 | Unregistered CommenterLC

A great way to get kids to eat their greens is blend them up in a smoothie. I love to add veggies, especially spinach and carrots to some frozen fruit ( strawberries blueberries cherries and peaches) and a little bit of orange juice concentrate and water to a blender and they drink it up. They especially love it if I serve them with straws. That is particularly fun!

May 27, 2011 | Unregistered CommenterLeAnn

Another great post! Most of the salads I love have been mentioned. But, my kids do love their green smoothie. These wonderful people have the recipe http://www.nourishingmeals.com/, but it involves pear and apple (about 60%) and then a kale/romaine mix for the other 40%.* Throw in some lemon juice to keep leftovers fresh and some flax seed for the omega 3. My kids can't get enough (ages 2 and 4) and will sometimes only drink their green smoothy on particularly picky/not-hungry days.

Your mention of Weston A Price and his wife hits home. I developed some significant health (auto-immune) problems when I started my family around the age of 30. Now, I hope my kids won't have the bone density and cavity issues that were part of the package that I inherited. We're trying to adopt more of the Weston A Price approach and already reaping the rewards.

*Tom's Medicine Chest Green Smoothy is in their cookbook.

May 29, 2011 | Unregistered CommenterMKS

You can see that I am falling behind in reading your posts, but I continue to visit when I find some time. I just wanted to share two anecdotes. One is that in my mid-twenties, I went about four years without seeing a dentist. It's embarrassing but true, and was due to a lack of dental insurance (and cash!). I was very worried about what the dentist would say when I finally went. I warned them in advance, and they set aside extra time for my appointment. However, when the hygenist was cleaning my teeth, she seemed surprised at their good condition. Finally, she asked me if I was a vegetarian! I hadn't realized at the time that my vegetarian diet would benefit my teeth. My other anecdote comes from a friend who is a pediatric dentist and who also has an MPH, an unusual combination in my experience. She told me that eating an apple has essentially the same effect as brushing one's teeth. I do still brush my teeth, of course! But I enjoy my apples that much more. :-)

June 11, 2011 | Unregistered CommenterSheela

Thanks for sharing such useful information. The information provided is very very niche and this information is not available so easily. Therefore I thank the writer for the useful input.

Acai berry

December 19, 2011 | Unregistered Commentermayank

Yes, dental cavities are usually overlooked as just part of a common phase a child goes through. The food a household ingest mainly contribute to the development of such cavities. Its factors are mostly curable, apart from genetics. Preventive dentistry is a surefire way to prevent these harmful substances that may grow on our family's healthy grinders.

-Calandra Janocha

January 23, 2012 | Unregistered CommenterCalandra Janocha

My husband and I laughed quite a bit when we took our young daughters to a new dentist and there, in the waiting room, was a plate of chocolate chip cookies provided as a refreshment for the patients. Looks like job security to me!

February 19, 2015 | Unregistered CommenterJennH

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